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Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 2/13/2007 2:17 PM (GMT -7)   
My testosterone level was low before I had the PC problem and I was hesitant to do anything about it as I feared it would only add to the PC problem so I am wondering if any of you have looked into increasing the testosterone level which might help with future impotency problems?
 
Motelmat

PSA 6.6, , Had biopsies On October 26, 06 with 5 positive and less than 30% cancer in any of them. Gleason 3+3


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 2/13/2007 4:23 PM (GMT -7)   
Hi Motelmat and welcome once again to the "other side".

I had low T levels prior to PCa and had been taking T injections every 2 weeks for about 2 years. As soon as I was dxed, the doc cut me off. No more testosterone due to its apparent effect on prostate cancer. I have been off T since November and have really noticed the effect of low T levels. I have hot flashes and a low energy level. I just have to live with it and will gladly if it means my PSA stays undetectable. Changes to my routine and exercise have helped a lot in the last 2 weeks. Its just one more life change that I can manage.

Low T level does affect my libido, as would be expected. I do some exercises that keep the blood flowing and take the blue pill occasionally. So far nothing usable but it is getting better. Luckily, I have a very understanding wife (of 51 years) and we are working the problem together. We are determined and convinced that PCa will not affect our relationship....

Jim
Age 72. Diagnosed 11/03/06. PSA 7.05. Stage T2B Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2B. Gleason 3+4. Cancer confined to prostate.
PSA on 1/3/07 - 0.04.  Next PSA on 4/4/07.
 
 "Patience is a virtue - especially when dealing with the effects of PCa."


djhouston
Regular Member


Date Joined Jan 2007
Total Posts : 68
   Posted 2/13/2007 4:50 PM (GMT -7)   

Hi Mat,

First of all, congratulations on your surgery being over.  I had the same pothole experience, even though I thought I prepared by getting one of those inflatable vinyl donuts to sit on as a shock absorber. Worked, partially.  I also had the testicular pain, especially after walking, which my doctor wanted me to do at one mile a day until the cath came out and then three miles a day after the cath came out. I have wondered about what happens with the produce of the jewels, because in the process of getting a prostatectomy, you get a vasectomy, too...with a vengence! Anybody's doctor tell them what happens to testicular output, when the road is permanently closed to the prostate/seminal vesicles?

Anyway, my testosterone was low, which is what got me into this situation in the first place. My internist found that my T level was in the 190s (300-900 is normal) when he first tested it, about 4 or 5 years ago. He said that he wanted me to be sure and get DREs and PSAs faithfully while I was on T replacement, because he said it could make PCa show up. Then, one day, he called and said I had a PSA of 4.4, "one toke over the line," as the old song goes, and to get to a urologist ASAP.  Well, I didn't plot all those years of the levels of PSA until after I had been diagnosed, but after I had surgery and was sitting around, I got the past labwork out and plotted it. It went up at an exponential rate.

Now, there are a lot of studies that deny that T gives you PCa, and, obviously, for you and me, low T doesn't protect you from getting it. I did some medical literature searches and found that there is a controversy about giving T supplementation before or after the diagnosis and treatment of PCa. There were many papers that relate low T with an increased risk of PCa (go figure). On the other hand, chemical and surgical castration are used to treat advanced PCa. 

There is a Dr. Morgentaler at Harvard Medical School and a Dr. Kaufman in Colorado who say that if a person has low T they should get supplementation, because it doesn't give one PCa, and the adverse health effects of low T are not good either--osteoporosis, cardiovascular problems, increased body fat, sluggishness and fatigue, loss of libido and erectile dysfunction, and depression.  My doctor did a T level on me at the same time I got my first post-op PSA, and it was still in the 190s (see my signature area).  He told me I should get on the supplementation, that if I came in with non-advanced PCa and a normal level of T, he wouldn't castrate me at that point. So, supplementation is bringing one up to normal.  For the controversy, you can go to the National Library of Medicine site called Pub Med (for real!), http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed, and in the search window, type in testosterone-supplementation AND prostate-cancer.  This will give you a few studies and some more links to other studies. If you click on the name(s) in the bibligraphical list, it will give you summaries of these reports.

I believe all this, in principle, but am waiting to see at least another undetectable PSA before I go back for the supplementation (per Swimom's suggestion). There was another guy, either on this website or on the other website I used to frequent on www.msnbc.com, the forum on the site for their series about PCa called Low Blow (see, low T can affect your memory, as well), who said he felt like dirt before getting on T supplementation, but felt like a new man afterwards.  So, it's very tempting.  I am up for another PSA at the end of this month, and have an appointment with the endocrine guy in the Baylor Urology Department to talk about getting back on AndroGel.  I'll let you know what happens. 

Keep up the good work of healing,
Your partner in daVinci prostatectomies and low testosterone
dj
dj's stats:
PSA (10/04): 2.9; PSA (2/06):4.4, on Androgel (serum T about 450) at age 56; negative DRE, no symptoms.
PSA (5/06):5.7 with a free PSA% of 8, OFF Androgel (serum T 163). 
Biopsy (5/06): 4/12 samples positive; postitive samples only on right side; max Gleason 4+3=7 (in 2 of the 4 -from area nearest bladder.
DaVinci robotic-assisted laparoscopic radical prostatectomy + bladder lift + Right nerve plastic surgery (8/23/06).
Catheter out 4 weeks postop, due to internal pinhole leak at bladder-urethra junction.
Final pathology report:T2c-both sides,but in capsule; neg. margins, neg. lymph nodes, neg. seminal vesicles; final max Gleason still 4+3=7.
Follow-up PSA (11/06): <0.008; serum T: 195 OFF Androgel (at present).


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 2/13/2007 4:53 PM (GMT -7)   

Dr Leibowitz at Compassionate Oncology Medical Group LA advocates use of hormone treatment. He has published  articles on his treatment, some of which are on his own website and also in the PAACT newsletters at www.paactusa.com 

I recall references to testosterone levels in some of his publications.


Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 2/13/2007 6:28 PM (GMT -7)   

djhouston,

thanks for the info.  I am supposed to get the catheter out this Friday (2/16) at the SF VA and I will ask them about testosterone replacement   VA has been real aware of futue impotency problems and the Doc told me after my surgery that they would start me on Cialis 3 times a week as soon as the catheter comes out, but he did not mention testosterone so I will ask him.

I dont know that a low testosterone affects the libido that much but I have sure noticed that it affects my efforts to keep the weight off and stay in shape and I seem to be alot more tired in the past few years that I have been aware of the decrease.

Please keep in touch on how you do on your end and I will let you know what VA says.

Mat

 


PSA 6.6, , Had biopsies On October 26, 06 with 5 positive and less than 30% cancer in any of them. Gleason 3+3.

Had Da Vinci surgery Feb 8, 2007 at SF VA hospital.  Home 2/9/07, supposed to get Mr. Foley out 2/16/07


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 2/14/2007 9:07 AM (GMT -7)   
Mat,

It might be unwise to begin T therapy this early in the game. You really do need to follow your PSA at least a couple of times before giving it a try. I am guessing your stats are good enough that everything will turn out just fine but still..... get a couple of serial PSA's. Paul waited just about a year. His symptoms are so severe without replacement therapy. I understand wanting to do something soon if you are anywhere near as symptomatic. Good Luck on Friday with the Foley.

Swim

Motelmat
Regular Member


Date Joined Nov 2006
Total Posts : 50
   Posted 2/14/2007 9:46 AM (GMT -7)   

Swim,

I think you are right, I will make sure everything is okay with the surgery results before I do anything else.

Mat


PSA 6.6, , Had biopsies On October 26, 06 with 5 positive and less than 30% cancer in any of them. Gleason 3+3.

Had Da Vinci surgery Feb 8, 2007 at SF VA hospital.  Home 2/9/07, supposed to get Mr. Foley out 2/16/07


djhouston
Regular Member


Date Joined Jan 2007
Total Posts : 68
   Posted 2/15/2007 4:54 PM (GMT -7)   
Hi, and thanks to Pete from refreshing my memory about his T experiences in his thread. I am taking Swimom's suggestion and am going to see what the second (or third) post op PSA says before I start the gel again (along the Uro-endocrinologist in my doc's group).

But low T is a drag. I lost 30 lbs, from the time of my diagnosis to my surgery, through sheer terror (and hardly eating) about having the Big C. Since the cath was out, and the initial scare was abated with the post-op pathology report, I have about gained it all back, along with the fatigue and sluggishness (the libido is deep-seated and never declined, even with the terror, and a T of 63 at one time--guess you could say it is hard-wired--yuk-yuk!). So, I can't wait to start the gel or T in some form again.

Good luck on the Cialis, Mat. But didn't the doctor tell you not to strain the area sexually for six weeks after the surgery? It seems like almost nobody on this website but me had to wait that long. It made sense to me because my doc's nurse-educator and the handouts they gave me before the surgery said that the delicate stitching of the urethra to the new bladder neck area needed to heal well before sex could be attempted. Not to be too graphic, but the motion of the area outside of the surgery site leading up to climax, and the muscle contractions around the area of the surgery site during climax, were things they wanted me to avoid so this tissue could heal. I was put on low doses of Viagra to keep the blood flow going, but not for sexual activity. Maybe other doctors have different criteria about when to start trying, but if they haven't said anything, I think that guys should ask about the stresses and strains on this surgical area.

dj
dj's stats:
PSA (10/04): 2.9; PSA (2/06):4.4, on Androgel (serum T about 450) at age 56; negative DRE, no symptoms.
PSA (5/06):5.7 with a free PSA% of 8, OFF Androgel (serum T 163). 
Biopsy (5/06): 4/12 samples positive; postitive samples only on right side; max Gleason 4+3=7 (in 2 of the 4 -from area nearest bladder.
DaVinci robotic-assisted laparoscopic radical prostatectomy + bladder lift + Right nerve plastic surgery (8/23/06).
Catheter out 4 weeks postop, due to internal pinhole leak at bladder-urethra junction.
Final pathology report:T2c-both sides,but in capsule; neg. margins, neg. lymph nodes, neg. seminal vesicles; final max Gleason still 4+3=7.
Follow-up PSA (11/06): <0.008; serum T: 195 OFF Androgel (at present).


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 2/16/2007 11:38 PM (GMT -7)   
When I did the blood work in prep for surgery, they said I had a high red blood cell count. I just saw a report that it could be caused by the testerosterone shots I was taking before being diagnosed with PCa. Some men in a testosterone replacement clinical trial had to leave the trial because of this.

Nothing important, just interesting...

Jim
Age 72. Diagnosed 11/03/06. PSA 7.05. Stage T2B Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2B. Gleason 3+4. Cancer confined to prostate.
PSA on 1/3/07 - 0.04.  Next PSA on 4/4/07.
 
 "Patience is a virtue - especially when dealing with the effects of PCa."

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